HHD3 Outcome 1

Determinants of Health

BEHAVIOURAL
DETERMINANTS OF HEALTH
Behavioural determinants of health
are actions or patterns of living of an
individual or a group that impact on
health, such as smoking, sexual
activity, participation in physical
activity and eating practices (NB:
these are adjustable actions!)

Physical activity levels

Dietary choices
Smoking tobacco
Alcohol consumption
Drug use or misuse
Use of health care i.e. going to the
doctors
Vaccination status
Risk taking behaviour

 Sexual behaviour

HHD3 Determinants of Health

Behavioural Determinants
Dietary Behaviour
The food people eat has a major impact on all
dimensions of health and health status of
individuals and population groups
Inadequate nutrition raises the risk of health concerns.
Those of a significant concern to Australians are:
- High intake of fats, particularly saturated fats
- High consumption of sodium (salt)
- High consumption of sugar
- Low calcium intake
- Low iron intake
- Inadequate intake of fruits and vegetables
Specific health concerns as a result from inadequate
consumption of fruits and vegetables include:
Colorectal cancer: Fibre, essentially found in fruits
and vegetables, reduces this risk by assisting in
waste removal from the digestive tract. In addition,
fruits and vegetables are low in fat, promoting
health of the digestive system.
Obesity, Hypertension, High Blood Cholesterol,
Impaired Glucose Regulation, Type 2 Diabetes and
Cardiovascular Disease: Individuals who eat
adequate amounts of fruits and vegetables feel
fuller for longer and are less likely to consume
energy dense foods (foods containing large
amounts of fat and sugar); fruit and veg are low in
fat
Birth Defects: Folate (found in a range of fruits and
vegetables) is vital for early development in the
woman as lack of folate has been linked to spina
bifida and other neural tube defects

Excessive intake of saturated fat is linked to a number

of health concerns, such as:
Obesity energy not used is stored as body fat
High blood cholesterol levels, Hypertension and
CVD - Saturated fats contain cholesterol therefore
increasing cholesterol levels. High blood
cholesterol levels contribute to high blood pressure
and cardiovascular disease. Obesity is a risk factor
for these conditions.
Impaired glucose regulation and Type 2 Diabetes
fat intake shown to reduce the impact of insulin in
the blood
Colorectal cancer there is a relationship between
high fat intake and colorectal although exact
nature of the relationship is not fully understood
Foods high in sodium can contribute to
hypertension
High amounts of sugar can be stored as fat if not
expended, can leads to issues such as obesity.
Sugar also provides nourishment for bacteria in the
mouth which can lead to decay on teeth.
Inadequate calcium intake can increase the chance
of osteoporosis (weak, brittle bones). Calcium
intake is important in women as their peak bone
mass are less than men and hormonal changes
occurring at menopause make it harder for women
to retain calcium increasing their risk of
osteoporosis.
Lack of iron in diet can contribute to anaemia, a
condition where there is a defiency of haemoglobin
in the blood.
http://www.abc.net.au/lateline/content/2015/s4225649.
htm - Cardiologist

says sugar and carbs

are the main cause of rising obesity

rates ABC Lateline (9.55)

HHD3 Determinants of Health

Behavioural Determinants
Physical Activity
Appropriate levels of physical activity is associated with a number of
health outcomes including:

Healthy body weight physical activity means the individual uses

more energy, which can contribute to healthy body weight (NOTE:
how many calories you consume is dependent on how much PA you
should be doing to maintain your weight)

Positive mental health and lower rates of depression,

anxiety and stress exercise can help to relieve stress and
produces endorphins, which are hormones that promote feelings of
wellbeing.

Weight baring activity helps ossify bones and

reduce the risk of osteoporosis later in life also
reduces the risk of broken bones
Cardiovascular activities (e.g. vigorous walking,
aerobics, swimming) enhances CV health
Physical inactivity is the 2nd largest contributing factor to
overall BOD in Australia 2nd only to tobacco smoking. More
Australians are leading sedentary/inactive lifestyles due to
increase in technology (entertainment, at work), less
active transport (less bike, walking, etc.), safety fears
Recommended Physical activity guidelines a sample (note not assessable)
Age group (years)
5-12
12-18
18+

Exercise intensity
Moderate- vigorous
Moderate-vigorous
Moderate

Duration
60 minutes
60 minutes
30 minutes

18+ (for extra

health benefits)

Vigorous

30

Frequency
Every day
Every day
Most days (5)
preferably all days
3.4 times per week

Moderate P.A activities include: walking (brisk), Riding a bike; Dancing

Vigorous P.A activities include: playing footy/soccer; Aerobics; Basketball;
Running

https://www.youtube.com/watch?v=F9vNiMrSYlY Sedentary behaviour risks

(2.50)
http://www.abc.net.au/catalyst/stories/3515000.htm - Exercise is medicine, 8.30,
Catalyst ABC

HHD3 Determinants of Health

Behavioural Determinants
Sexual Behaviours
When sexual acts are taken place between two individuals and bodily fluids such
as sperm, vaginal fluids, saliva or blood are exchanged, this is referred to as
unsafe sexual behaviours. This can occur through oral, vaginal or anal
intercourse. Unsafe sexual behaviours can result in a number of sexually
transmissible infections (also known as STIs), these include:
-

Gonorrhoea
Chlamydia - Although this infection is easily treated, chlamydia often
lacks symptoms, in which individuals are most likely to be unaware that
they carry the infection; therefore diagnosis may be difficult unless the
individual is tested. Untreated chlamydia can result in secondary
infections and infertility. The trends in chlamydia are becoming a concern
as the rates of infection have increased significantly over time.
Syphilis Rates for this infection have increased over the past 10 years.
This infection is similar to chlamydia, as it often shows no symptoms, but
once diagnosed is treatable. Untreated syphilis can progress through a
number of stages. Although most of the effects are not life threatening,
late-stage syphilis can lead to severe complications of the brain and heart
and can cause death. This infection is most prevalent amongst indigenous
Australians and men who have sex with the same gender.
HIV/AIDS

Each of these conditions can contribute to variations in health status amongst

individuals or populations. (NB: dont need to know each in detail)

Due to individuals being unaware that they could possibly be carrying an

STI or unaware of their partner carrying an STI, it is important to use
protection against possible infections (i.e, condom) and to have regular
check-ups at their local G.P or family planning clinic. If left untreated STIs
can cause infertility, poor health, problems in having a healthy baby and in
some cases, can lead to cancer.
In Australia, STIs typically contribute most to non-fatal disease burden
(YLDs)
Condoms are effective in preventing the transmission or passing on of
some sexually transmissible infections (STIs), however not all. Sexual
partners should be limited. The safest sex is when an individual has
intercourse with only one partner. Every time a new sexual partner is
added, there is exposure to diseases and infections from past sexual
encounters.

http://www.abc.net.au/lateline/content/2013/s3875687.htm STI epidemic; Australian

Broadcasting Corporation; Broadcast: 23/10/2013; 3.37

HHD3 Determinants of Health

Behavioural Determinants
Tobacco smoking
Tobacco smoking is the number 1 preventable risk factor
associated with health concerns such as CVD, respiratory
conditions (such as emphysema) and many forms of cancer
(lung, mouth cancer).
Smoke from tobacco can enter the lungs and can cause
lung cancer along with mouth and throat cancer (i.e.
where a cancerous tumour is formed)
More males than females in Australia smoke, however
females are rapidly gaining; more young females are now
taking smoking up than males
The extreme dangers of smoking were proven over 40
years ago and even now many Australian continue to
smoke and die from smoking related conditions
Hard addiction to break costs government millions each
year
https://www.youtube.com/watch?v=8rSrrSTW0UU Quit ad,
2008, 1-min

HHD3 Determinants of Health Behavioural

Determinants
Risk Taking Behaviour
Can be positive and negative

E.g. of negative risks:

Drink driving
Drug driving
Speeding whilst driving
Smoking marijuana
Trying drugs
Getting a lift off a stranger/intoxicated
Diving into a body of water that you havent tested
Swimming whilst drunk
Unprotected sex
Train surfing

Health status outcomes from RTBs:

- Increased risk of injury, STIs, premature death, brain
damage, drowning, etc.
Populations most likely to engage in these behaviours:
- Teenagers are more likely to engage in risky behaviours =
brain still developing, hormones, desire to impress peers =
all reasons
- Males
- Low socioeconomic status (SES) low levels of education
- Under influence of drugs/alcohol
- Individuals with peers who engage in the behaviors
mentioned above

https://www.youtube.com/watch?v=Al25O1MW8dM TAC ad (3-mins)

http://www.smh.com.au/nsw/sydney-university-student-carl-salomon-drownsafter-night-out-20150205-1378b7.html - Sydney University student Carl Salomon drowns after
night out (1.03)

HHD3 Determinants of Health Behavioural

Determinants
Drug misuse

The term drug refers to chemical substances that have an effect on

the body. The development of drugs for medical purposes has been
largely responsible for the increase in life expectancy in Australia
over the past century. When drugs are misused, however, it can lead
to a range of health problems.

Drug misuse refers to abuse of both prescription and illicit drugs.

Prescription drugs can be used to enhance health, but can be as
detrimental as illicit drugs when misused.

Like any addiction, drugs have the ability to control peoples lives.
As well as the physiological and mental effects, drug users often find
it hard to maintain employment, may struggle financially, may lose
friends and family members and may resort to crime to support
their habit.

Some of the more common drugs that are misused include:

painkillers

sleeping tablets

marijuana

hallucinogens (such as LSD)

amphetamines (such as speed and ice)

ecstasy

cocaine

heroin.

Some of the ways in which drug misuse can contribute to variations in

health status include an increased risk of:

mental illness

brain damage

birth defects

lung cancer (when smoked)

respiratory problems (when smoked)

HIV and hepatitis (when injected)

accidents (such as car accidents and violence).

http://www.abc.net.au/4corners/stories/2014/10/20/4108571.htm - Ice
Rush - 4-corners, 2014, 45-mins

HHD3 Determinants of Health

Behavioural Determinants
Accessing healthcare (behavior of
going to the doctor)
Going to doctors, physiotherapist,
chiropractor, dentist = all forms of
accessing healthcare
Females are more likely to go to doctors
than males
Males are more likely to die from a
treatable condition because of it going
undiagnosed in the early stages
Going to doctor = identifying and
therefore treating health issues in early
onset and hence more likely to be able
to cure

 Other populations who go to the doctor

least:
- Low SES
- Rural and remote areas
- Men
- Indigenous

HHD3 Determinants of Health

Behavioural Determinants
Vaccination behavior
Vaccination provides protection against certain
diseases including:
- Measles
- Mumps
- Tetanus
- Whooping cough
- Hepatitis B
- Polio
- Diptheria

Some vaccinations are not funded by the government

and hence have to be paid for by the individual,
therefore low income earners/low SES populations are
less likely to get them

Some parents elect to not vaccinate/immunize their

children which increases the risk of suffering from
those conditions that could be immunized against
Immunizations/vaccinations for the flu and pneumonia
are made free to certain populations in Australia
(including all indigenous Australians aged over 50, all
Australians aged over 65, etc.) however not all people
amongst these population groups elect to take up this
offer

http://www.abc.net.au/7.30/content/2015/s4216501.htm Australian Broadcasting Corporation; Broadcast: 14/04/2015;

5.50

HHD3 Determinants of Health

Behavioural Determinants
Alcohol consumption
Appropriate alcohol consumption = approximately
2 standard drinks a day for adults over 18
Excessive alcohol consumption = drinking large
amounts of alcohol in one sitting (binge drinking)
and/or over a long period of time
Conditions associated with excessive drinking:
- Liver disease
- Obesity (most alcohol = calorie dense)
- Some cancers (liver; colorectal cancer)
- Depression
- Type 2 Diabetes
- CVD
Short term health impact of excessive alcohol
consumption:
- Accidents (car, pedestrian, falls, trips) and
therefore injuries
- Drowning
- Injuries from violence

http://www.abc.net.au/lateline/content/2014/s4057583.htm
Lateline, ABC, 3.45

http://www.abc.net.au/btn/story/s2003295.htm - impact of
alcohol (Behind the news, 4-mins)